Provider Demographics
NPI:1124345145
Name:STONE-GOLDMAN, JUDY R (PHD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:R
Last Name:STONE-GOLDMAN
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15825 SE 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-5016
Mailing Address - Country:US
Mailing Address - Phone:206-795-3546
Mailing Address - Fax:
Practice Address - Street 1:15825 SE 13TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-5016
Practice Address - Country:US
Practice Address - Phone:206-795-3546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00001801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist